Female Fencers and ACL Injuries

[jjefferies]

Picked this up from a NY Times article on women's sport injuries and focused on the ACL injuries. Obviously here on f.net we don't have hard numbers for fencing. But one wonders if the same statistics hold true for women in fencing.

The whole article. May require you to register with the NY Times:
http://www.nytimes.com/2008/05/11/ma...tml?8au&emc=au

Starting on page 4:
"If girls and young women ruptured their A.C.L.s at just twice the rate of boys and young men, it would be notable. Three times the rate would be astounding. But some researchers believe that in sports that both sexes play, and with similar rules, soccer, basketball, volleyball, female athletes rupture their A.C.L.s at rates as high as five times that of males.

Anthony Beutler, a major in the U.S. Air Force and a professor at the School of Medicine of the Uniformed Services University in Bethesda, Md., is among the cadre of doctors, scientists and researchers trying to crack the code of A.C.L. injuries. In 2001-2, he was a sports-medicine fellow at the Naval Academy, where he served as the physician for the women's soccer team. Seven women were lost that season to A.C.L. ruptures. Beutler, already immersed in A.C.L. research, was still stunned. I thought to myself, What in the heck is going on here? he said. Last season, the women's team at Navy suffered three torn A.C.L.s. They thought that was great, a fortunate year, he told me. Think about that. Just three. It's bizarre.

Men also tear their A.C.L.'s, most frequently in football and from direct blows to the leg. But even football players, according to N.C.A.A. statistics, do not rupture their A.C.L.'s during their fall seasons at the rates of women in soccer, basketball and gymnastics. The N.C.A.A.'s Injury Surveillance System tracks injuries suffered by athletes at its member schools, calculating the frequency of certain injuries by the number of occurrences per 1,000 athletic exposures practices and games. The rate for women's soccer is 0.25 per 1,000, or 1 in 4,000, compared with 0.10 for male soccer players. The rate for women's basketball is 0.24, more than three times the rate of 0.07 for the men. The A.C.L. injury rate for girls may be higher perhaps much higher than it is for college-age women because of a spike that seems to occur as girls hit puberty. "

An interesting issue in all sports. But does anyone have anecdotal indication that it's a problem in fencing?

[keith]

Originally Posted by jjefferies

An interesting issue in all sports. But does anyone have anecdotal indication that it's a problem in fencing?

To answer with hearsay - I would be amazed if it wasn't. One of the issues with the injuries that occur in female athletes is that the ACL (and other tendons) go more frequently during 'normal' athletic endeavor, it isn't that they fall/twist/collide/push harder three times more than male athletes.

[Peach]

Anecdotal evidence? I have known several male fencers who got ACL injuries as a result of fencing, but no female fencers. I've had female friends who have broken arms while retreating and falling, who have gotten their arteries nicked by blades, or who have been stabbed through the hand and up the arm, but no ACL injuries.

[seak]

There are two answers depending on which question you ask:

a) Do female fencers have more ACL injuries then male fencers? Probably (women tend to have more ACL tears period)
b) Do you see the same rate (or a super high rate) of ACL tears in fencing, at the same level as women's bball or soccer? No
This is purely from anecdotal evidence, but if you look at women's varsity fencing teams which have 12+ fencers on them to women's basketball teams or soccer, you will see far fewer ACL injuries.

ACL injuries tend to happen when one is cutting, or twisting, and many tears in both Men and Women aren't caused by contact. Soccer and Basketball both involve a lot of sideways cutting, fencing doesn't.

I have also seen studies that say that due to the physical make-up of women's legs and knees they are more susceptible to ACL tears, I will absolutely believe this. Does this mean I'm going to quit playing sports, or want special rules made to protect my knees or delicate physical nature (hah)? Absolutely, positively not.

[Peach]

I want my delicate physical nature protected, dernit. Like all human beings, I am vulnerable to being hit by a bus or having a piano dropped on me.

You beat me to the response--the ACL injuries I know of from fencing resulted from things like stepping on a floor reel while retreating in one case, and in another case two big male epeeists infighting and when one stepped on the other's foot, the steppee twisted and tore.

[MyrddinsPrecint]

So, in the past four years, there are have been 5 major knee injuries on the Smith Team. Two I'm not entirely sure what happened, and the other three were ACL tears. Only two of the ACL tears happened during fencing, both happened in competition.

Knee injuries or pain have stopped lots of people from fencing. No other body part has kept people away permanently. (mono has kept people away temporarily)

[Squall_Leonhart]

While this sport does have its idiosyncracies, I think the perspective that needs to be addressed is on comparative anatomy and sports performance. Here comes the offending ugly to some people.
On average, women are physically weaker than men, athletes or not.
Women, on average, have less muscles, thinner/smaller ligaments, tendons to support their skeletal structure along with everything else needing balance and tension in their body.
Often times in sports medicines, injuries could have been reduced with the help of local muscles to compensate for impact (if anticipated by the athlete, or reflex, etc.).
The muscles and other ligaments surrounding the ACL, if engaged (muscles), can help support/"strut" the ACL and help reduce injury. Because men TEND to be more athletic (muscles can compensate the initial blow), their ligaments and muscles are better prepared to withstand the impact which causes the injury.
I have not intensively studied ACL.
A counter argument would be that women and men face different intensities of impact (a man kicking one in the leg in soccer is probably not as strong as a woman kicking one's leg in the sport). However, both of them are athletes, and being frail human beings we are, it does not take much force to break our bones and rip our whatevers.

[MyrddinsPrecint]

Actually, women tend to have wider hips, which means that the legs are at a different angle, which puts tension on the ACLs in a different way than men, making them easier to tear.

Supposedly. I'm not exactly a sports medicine expert.

[BrodeurNJD30]

Its called the Q angle. Which is the angle from the hip to the ankle with the knee at the apex. the greater the Q angle the more likely an ACL injury is possible. usually occurs in a twisting motion.

[bigdawg2121]

So what you're saying is that my dainty waist means that I'm less likely to be injury prone?

[Peach]

Originally Posted by bigdawg2121

So what you're saying is that my dainty waist means that I'm less likely to be injury prone?

Only if your hips are equally dainty.

[Capt. Slo-mo]

I'm not fully comfortable being asked to ponder BigDawgs' hips.

Dainty or not.

[finnfence]

I remember someone mentioning that when I was fencing in New York, and there were a couple of female fencers I knew who had had ACL injuries. I also know female athletes in other sports who have that problem. I speculate that it happens because we're stretchier, and our knees tend to be more rotate-able than they should be, and then we tend to do things like squirming or locking our joints or not developing enough muscle around the knee to take stress off the joint when something bad happens, and so, well, the wind it blew, the cow product it flew....

That's happened to me, anyhow. I very stupidly counterattacked with a step forward, locked elbow, locked back knee, into someone's flunge when I was goofing around in a mixed saber competition here in Helsinki. About 160 pounds of bouncy sabrist came crashing into my belleguard (completely my fault, and I'm just glad I didn't injure him as well), and since my joints were locked, my elbow bones in my forearm went "sproing", separating slightly wider than they ought, and my body rotated backwards...except that my shoes were really sticky, so my back foot and lower leg stayed where they were, while my upper leg rotate backwards. I've always been kind of hyper-stretchy, so I didn't actually tear anything in the knee, but it's been two years and my knee and elbow still aren't quite right. The tendons in there are just loose, and if I'm not careful I get that weird leg-floating-around-oddly feeling that people who have torn their ACLs describe. To me, it's just the price of my own stupidity and my own flexibility - sort of the flip side of what is normally an advantage (the flexibility, I mean...can't say I've ever noticed a lot of advantage from my lack of fencing IQ)